Keratosis Pilaris: Rough Bumps on Your Arms Explained

Keratosis pilaris is a common, harmless skin condition. It causes tiny, rough bumps, mostly on the backs of the upper arms and the thighs. Each bump is a hair follicle blocked by a plug of keratin, a protein in skin. It is not an infection and not a sign of poor hygiene. There is no cure, but daily care makes the skin smoother, and it often fades with age.

Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).

For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.

What does keratosis pilaris look like?

The British Primary Care Dermatology Society (PCDS) describes tiny scaly bumps of 1 to 2 mm. They feel rough, like sandpaper. The usual places are the outer upper arms and the fronts of the thighs. The cheeks, bottom, chest and back can also be affected.

On pale skin the bumps look red or pink. On brown or black skin they look darker than the skin around them. They do not usually hurt. Some people find them itchy, especially when the skin is dry.

In the UK and US people often call it "chicken skin". In Spain you will hear queratosis pilaris, queratosis pilar or piel de gallina.

Why do I have keratosis pilaris?

Keratin builds up and blocks the opening of the hair follicle. The NHS says no one knows exactly why this happens. A few things make it more likely:

• Family. It often runs in families. If a parent has it, you are more likely to have it.
• Eczema and very dry skin. The PCDS says it is more common with atopic eczema and with ichthyosis vulgaris, an inherited dry-skin condition.
• Dry skin and cold weather. Dry air in winter makes it worse. Many people see it improve in summer.
• Age. It is common in children and teenagers.

It is not caused by diet, dirt or anything you did. You cannot catch it or pass it on.

Does keratosis pilaris go away on its own?

Often, but not always. The PCDS says it usually improves over time and often clears in adults. MedlinePlus says it may fade slowly with age. The NHS is more cautious: most people have it for years, and it may clear in the end.

So it is best to think of it as something to manage, not a problem to fix once. The good news is that it is harmless either way.

What is the best keratosis pilaris treatment?

Treatment is optional. It is only needed if the bumps bother you. The American Academy of Dermatology (AAD) and the NHS agree on a simple daily routine:

• Wash gently. Use lukewarm water and a mild, unscented, soap-free wash. Keep showers short.
• Pat dry. Do not rub the skin with the towel.
• Moisturise on damp skin. The AAD advises a thick cream or ointment within 5 minutes of bathing. Use it again whenever the skin feels dry.
• Exfoliate softly. A soft washcloth is enough. Harsh scrubs make the bumps redder.
• Leave the bumps alone. Picking and scratching can leave marks.

The AAD also warns that shaving and waxing can cause more bumps. Self-tanning products make them easier to see.

Which creams help keratosis pilaris?

The most useful creams soften the keratin plugs. MedlinePlus and the AAD list these ingredients:

• Urea (urea).
• Lactic acid (ácido láctico) or glycolic acid.
• Salicylic acid (ácido salicílico).

The PCDS also suggests creams with urea or salicylic acid. In Spain, a pharmacist (farmacéutico) can tell you which creams with these ingredients you can buy without a prescription.

Use the cream as the label says. The AAD warns that using too much can leave the skin raw. If it stings or turns red, stop for a few days. Be patient: MedlinePlus says improvement often takes months, and the bumps tend to come back when you stop.

For young children, start with a plain, unscented moisturiser. The MSD Manual notes that acid creams can burn and sting in young children.

What can a doctor prescribe?

If good daily care is not enough, a doctor may suggest one of these:

• A retinoid cream, made from vitamin A, such as tretinoin or adapalene. The PCDS says it can reduce roughness but may irritate the skin. In Spain these creams are licensed for acne, so using one for keratosis pilaris is a doctor's decision. The Spanish leaflet for tretinoin says not to use it in pregnancy or when trying to get pregnant. Read more in our guide to tretinoin in Spain.
• A short course of a steroid cream for very red, inflamed patches. The PCDS advises using it for a few days at a time, not long term, because steroids can thin the skin.
• Laser treatment for marked redness, especially on the face. The PCDS notes this is not available on the NHS. It is usually a private treatment.

Most people never need more than a good moisturiser.

Is it keratosis pilaris, eczema or acne?

A doctor can usually tell just by looking. Tests are rarely needed. Some pointers:

• Eczema causes itchy, dry, red patches, often in the elbow and knee creases. The two often occur together.
• Acne on the cheeks can look similar. MedlinePlus notes that facial bumps from keratosis pilaris are sometimes mistaken for acne.
• Folliculitis is an infection of the hair follicles. The spots are often tender and filled with pus.

When should you see a doctor?

• The bumps bother you and do not improve with creams from the pharmacy.
• The skin becomes very itchy, sore or inflamed.
• You are not sure it is keratosis pilaris.
• You notice scarring, or patchy loss of eyebrow hair. The PCDS notes rare forms that can do this.
• The look of your skin is affecting your mood or confidence.

See a doctor today if a spot becomes hot, swollen and very painful, or redness spreads and you have a fever. That is not keratosis pilaris.

Talking it through with a doctor by video

Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:

• Look at the bumps on camera, in good light.
• Ask about eczema, allergies and family history.
• Review the products you use and build a simple routine.
• Tell you if a prescription cream, a dermatologist or an in-person exam would help.

He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.

A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.

This guide is general information. It does not replace a consultation with your doctor.

Frequently asked questions

Sources

• NHS (nidirect): Keratosis pilaris
• Primary Care Dermatology Society: Keratosis pilaris
• MedlinePlus: Keratosis pilaris
• American Academy of Dermatology: Keratosis pilaris self-care
• MSD Manual: Queratosis pilosa (in Spanish)

Related guides

• Eczema care online
• Eczema and psoriasis: preparing follow-up photos
• Tretinoin in Spain: uses and safety
• Online doctor for minor skin issues in Spain
• Impetigo: symptoms and treatment
• Urgent Care video visit